On Nov 27, 2013, at 5:52 AM, Lisa Paul <> wrote:
What would cause nipples to lose their outer protective layer within 1 day
of birth?  Outside of a poor latch and tongue tie.  If a nipple looked
brown and crusty during pregnancy, what could that indicate?
------------------------
Hyperkeratosis is an overgrowth of skin cells on the nipple that sometimes
occurs during pregnancy.  These appear as thick, crusty patches on the tips
of the nipples.  They tend to loosen during the early breastfeedings and
come off in the first day or two.  The skin under the patches is very
sensitive because it has been "protected" under the patch and never been
exposed air, friction from clothing, etc.

The baby may swallow the crusty patch pieces and this is not harmful.  The
mom will want to pull them off, but she should resist because that will
cause more painful exposure.

This mom will have more nipple soreness than average because of this newly
exposed, thin, sensitive, new skin.  Careful positioning and latch
techniques along with use of Lansinoh or PureLan will help.  I have also
suggested cracked ice inside a wash cloth, applied to the nipple for 10
minutes at a time (just before a feeding, right after, anytime in 24 hours)
as a comfort measure.  Just be sure to us the lanolin product after wards
because water is drying to the skin.

Barb Berges BS, RN, IBCLC
near Cleveland, Ohio

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